Mechanisms of Injury
Signs and Symptoms
Imaging and Other Diagnostic Studies
Pathoanatomy and Applied Anatomy
Operative Treatment of Elementary Acetabular Fracture Types
Operative Treatment of Associated Acetabular Fracture Types
Percutaneous Operative Treatment
Outcomes of Operative Treatment
Management of Expected Adverse Outcomes and Unexpected Complications
Posttraumatic Arthritis and Osteonecrosis of the Femoral Head
Iatrogenic Nerve Injury
Author’s Preferred Treatment
Summary, Controversies, and Future Directions
NOTE: “X” in bold denotes a preferred approach.
After Moed BR, Israel H. Heterotopic ossification prevention and treatment: what is the best way to prevent heterotopic ossification following acetabular fracture fixation? In: Wright JG, ed. Evidence-based Orthopaedics. Philadelphia, PA: Saunders Elsevier; 2009:353–359.
(From Letournel E, Judet R. Fractures of the Acetabulum. 2nd ed. Berlin: Springer-Verlag, 1993.)
Nondisplaced fractures, excluding those involving the posterior wall, can be treated by close observation (Fig. 47-94). Any evidence of subsequent fracture displacement necessitates operative intervention. Nondisplaced posterior wall fractures should be evaluated with stress examination under anesthesia. Instability demonstrated with this examination warrants open reduction and internal fixation. Stable nondisplaced fractures can be treated nonoperatively. Displaced fractures require operative treatment, preferably open reduction and internal fixation. As detailed in the foregoing sections, the specific surgical tactic is dictated by many factors, the most important being the exact fracture morphology.